Blue Button 2.0 Implementation Guide
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@prefix fhir: <https://bluebutton.cms.gov/assets/ig/> . @prefix owl: <http://www.w3.org/2002/07/owl#> . @prefix rdfs: <http://www.w3.org/2000/01/rdf-schema#> . @prefix xsd: <http://www.w3.org/2001/XMLSchema#> . # - resource ------------------------------------------------------------------- a fhir:CodeSystem; fhir:nodeRole fhir:treeRoot; fhir:Resource.id [ fhir:value "clm-mdcr-non-pmt-rsn-cd"]; fhir:DomainResource.text [ fhir:Narrative.status [ fhir:value "generated" ]; fhir:Narrative.div "<div xmlns=\"http://www.w3.org/1999/xhtml\"><h2>Claim Medicare Non Payment Reason Code</h2><div><p>The reason that no Medicare payment is made for services on an institutional claim. Source: https://bluebutton.cms.gov/resources/variables/clm<em>mdcr</em>non<em>pmt</em>rsn_cd</p>\n</div><p>This code system https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd defines the following codes:</p><table class=\"codes\"><tr><td><b>Code</b></td><td><b>Display</b></td><td><b>Definition</b></td></tr><tr><td>A<a name=\"clm-mdcr-non-pmt-rsn-cd-A\"> </a></td><td>Covered worker's compensation (Obsolete)</td><td>Covered worker's compensation (Obsolete)</td></tr><tr><td>B<a name=\"clm-mdcr-non-pmt-rsn-cd-B\"> </a></td><td>Benefit exhausted</td><td>Benefit exhausted</td></tr><tr><td>C<a name=\"clm-mdcr-non-pmt-rsn-cd-C\"> </a></td><td>Custodial care – non-covered care (includes all 'beneficiary at fault' waiver cases) (Obsolete)</td><td>Custodial care – non-covered care (includes all 'beneficiary at fault' waiver cases) (Obsolete)</td></tr><tr><td>E<a name=\"clm-mdcr-non-pmt-rsn-cd-E\"> </a></td><td>HMO out-of-plan services not emergency or urgently needed (Obsolete)</td><td>HMO out-of-plan services not emergency or urgently needed (Obsolete)</td></tr><tr><td>E<a name=\"clm-mdcr-non-pmt-rsn-cd-E\"> </a></td><td>MSP cost avoided - IRS/SSA/HCFA Data Match (eff. 7/00)</td><td>MSP cost avoided - IRS/SSA/HCFA Data Match (eff. 7/00)</td></tr><tr><td>F<a name=\"clm-mdcr-non-pmt-rsn-cd-F\"> </a></td><td>MSP cost avoid HMO Rate Cell (eff. 7/00)</td><td>MSP cost avoid HMO Rate Cell (eff. 7/00)</td></tr><tr><td>G<a name=\"clm-mdcr-non-pmt-rsn-cd-G\"> </a></td><td>MSP cost avoided Litigation Settlement (eff. 7/00)</td><td>MSP cost avoided Litigation Settlement (eff. 7/00)</td></tr><tr><td>H<a name=\"clm-mdcr-non-pmt-rsn-cd-H\"> </a></td><td>MSP cost avoided Employer Voluntary Reporting (eff. 7/00)</td><td>MSP cost avoided Employer Voluntary Reporting (eff. 7/00)</td></tr><tr><td>J<a name=\"clm-mdcr-non-pmt-rsn-cd-J\"> </a></td><td>MSP cost avoid Insurer Voluntary Reporting (eff. 7/00)</td><td>MSP cost avoid Insurer Voluntary Reporting (eff. 7/00)</td></tr><tr><td>K<a name=\"clm-mdcr-non-pmt-rsn-cd-K\"> </a></td><td>MSP cost avoid Initial Enrollment Questionnaire (eff. 7/00)</td><td>MSP cost avoid Initial Enrollment Questionnaire (eff. 7/00)</td></tr><tr><td>N<a name=\"clm-mdcr-non-pmt-rsn-cd-N\"> </a></td><td>All other reasons for non-payment</td><td>All other reasons for non-payment</td></tr><tr><td>P<a name=\"clm-mdcr-non-pmt-rsn-cd-P\"> </a></td><td>Payment requested</td><td>Payment requested</td></tr><tr><td>Q<a name=\"clm-mdcr-non-pmt-rsn-cd-Q\"> </a></td><td>MSP cost avoided Voluntary Agreement (eff. 7/00)</td><td>MSP cost avoided Voluntary Agreement (eff. 7/00)</td></tr><tr><td>R<a name=\"clm-mdcr-non-pmt-rsn-cd-R\"> </a></td><td>Benefits refused, or evidence not submitted</td><td>Benefits refused, or evidence not submitted</td></tr><tr><td>T<a name=\"clm-mdcr-non-pmt-rsn-cd-T\"> </a></td><td>MSP cost avoided - IEQ contractor (eff. 9/76) (obsolete 6/30/00)</td><td>MSP cost avoided - IEQ contractor (eff. 9/76) (obsolete 6/30/00)</td></tr><tr><td>U<a name=\"clm-mdcr-non-pmt-rsn-cd-U\"> </a></td><td>MSP cost avoided - HMO rate cell adjustment (eff. 9/76) (Obsolete 6/30/00)</td><td>MSP cost avoided - HMO rate cell adjustment (eff. 9/76) (Obsolete 6/30/00)</td></tr><tr><td>V<a name=\"clm-mdcr-non-pmt-rsn-cd-V\"> </a></td><td>MSP cost avoided - litigation settlement (eff. 9/76) (Obsolete 6/30/00)</td><td>MSP cost avoided - litigation settlement (eff. 9/76) (Obsolete 6/30/00)</td></tr><tr><td>W<a name=\"clm-mdcr-non-pmt-rsn-cd-W\"> </a></td><td>Worker's compensation (Obsolete)</td><td>Worker's compensation (Obsolete)</td></tr><tr><td>X<a name=\"clm-mdcr-non-pmt-rsn-cd-X\"> </a></td><td>MSP cost avoided - generic</td><td>MSP cost avoided - generic</td></tr><tr><td>Y<a name=\"clm-mdcr-non-pmt-rsn-cd-Y\"> </a></td><td>MSP cost avoided - IRS/SSA data match project (obsolete 6/30/00)</td><td>MSP cost avoided - IRS/SSA data match project (obsolete 6/30/00)</td></tr><tr><td>Z<a name=\"clm-mdcr-non-pmt-rsn-cd-Z\"> </a></td><td>Zero reimbursement RAPs -- zero reimbursement made due to medical review intervention or where provider specific zero payment has been determined. (effective with HHPPS - 10/00)</td><td>Zero reimbursement RAPs -- zero reimbursement made due to medical review intervention or where provider specific zero payment has been determined. (effective with HHPPS - 10/00)</td></tr><tr><td>00<a name=\"clm-mdcr-non-pmt-rsn-cd-00\"> </a></td><td>MSP cost avoided - COB Contractor</td><td>MSP cost avoided - COB Contractor</td></tr><tr><td>12<a name=\"clm-mdcr-non-pmt-rsn-cd-12\"> </a></td><td>MSP cost avoided - BCBS Voluntary Agreements</td><td>MSP cost avoided - BCBS Voluntary Agreements</td></tr><tr><td>13<a name=\"clm-mdcr-non-pmt-rsn-cd-13\"> </a></td><td>MSP cost avoided - Office of Personnel Management</td><td>MSP cost avoided - Office of Personnel Management</td></tr><tr><td>14<a name=\"clm-mdcr-non-pmt-rsn-cd-14\"> </a></td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch</td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch</td></tr><tr><td>15<a name=\"clm-mdcr-non-pmt-rsn-cd-15\"> </a></td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006)</td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006)</td></tr><tr><td>16<a name=\"clm-mdcr-non-pmt-rsn-cd-16\"> </a></td><td>MSP cost avoided - Liability Insurer VDSA (eff. 4/2006)</td><td>MSP cost avoided - Liability Insurer VDSA (eff. 4/2006)</td></tr><tr><td>17<a name=\"clm-mdcr-non-pmt-rsn-cd-17\"> </a></td><td>MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006)</td><td>MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006)</td></tr><tr><td>18<a name=\"clm-mdcr-non-pmt-rsn-cd-18\"> </a></td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006)</td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006)</td></tr><tr><td>19<a name=\"clm-mdcr-non-pmt-rsn-cd-19\"> </a></td><td>SEE NOTE4: Coordination of Benefits Contractor 11119 (see CMS Change Request 7906 for identification of the contractor.)</td><td>SEE NOTE4: Coordination of Benefits Contractor 11119 (see CMS Change Request 7906 for identification of the contractor.)</td></tr><tr><td>21<a name=\"clm-mdcr-non-pmt-rsn-cd-21\"> </a></td><td>MSP cost avoided - MIR Group Health Plan (eff. 1/2009)</td><td>MSP cost avoided - MIR Group Health Plan (eff. 1/2009)</td></tr><tr><td>22<a name=\"clm-mdcr-non-pmt-rsn-cd-22\"> </a></td><td>MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009)</td><td>MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009)</td></tr><tr><td>25<a name=\"clm-mdcr-non-pmt-rsn-cd-25\"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005)</td><td>MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005)</td></tr><tr><td>26<a name=\"clm-mdcr-non-pmt-rsn-cd-26\"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005)</td><td>MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005)</td></tr><tr><td>42<a name=\"clm-mdcr-non-pmt-rsn-cd-42\"> </a></td><td>SEE NOTE4: Coordination of Benefits Contractor 11142 (see CMS Change Request 7906 for identification of the contractor.)</td><td>SEE NOTE4: Coordination of Benefits Contractor 11142 (see CMS Change Request 7906 for identification of the contractor.)</td></tr><tr><td>43<a name=\"clm-mdcr-non-pmt-rsn-cd-43\"> </a></td><td>SEE NOTE4: Coordination of Benefits Contractor 11143 (see CMS Change Request 7906 for identification of the contractor.) Effective 4/1/02, the Medicare nonpayment reason code was expanded to a 2-byte field. The NCH instituted a crosswalk from the 2-byte code to a 1-byte character code. Below are the character codes (found in NCH & NMUD). At some point, NMUD will carry the 2-byte code but NCH will continue to have the 1-byte character code.</td><td>SEE NOTE4: Coordination of Benefits Contractor 11143 (see CMS Change Request 7906 for identification of the contractor.) Effective 4/1/02, the Medicare nonpayment reason code was expanded to a 2-byte field. The NCH instituted a crosswalk from the 2-byte code to a 1-byte character code. Below are the character codes (found in NCH & NMUD). At some point, NMUD will carry the 2-byte code but NCH will continue to have the 1-byte character code.</td></tr><tr><td>!<a name=\"clm-mdcr-non-pmt-rsn-cd-.33\"> </a></td><td>MSP cost avoided - COB Contractor ('00' 2-byte code)</td><td>MSP cost avoided - COB Contractor ('00' 2-byte code)</td></tr><tr><td>@<a name=\"clm-mdcr-non-pmt-rsn-cd-.64\"> </a></td><td>MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code)</td><td>MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code)</td></tr><tr><td>#<a name=\"clm-mdcr-non-pmt-rsn-cd-.35\"> </a></td><td>MSP cost avoided - Office of Personnel Management ('13' 2-byte code)</td><td>MSP cost avoided - Office of Personnel Management ('13' 2-byte code)</td></tr><tr><td>$<a name=\"clm-mdcr-non-pmt-rsn-cd-.36\"> </a></td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 2-byte code)</td><td>MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 2-byte code)</td></tr><tr><td>*<a name=\"clm-mdcr-non-pmt-rsn-cd-.42\"> </a></td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) ('15' 2-byte code) (eff. 4/2006)</td><td>MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) ('15' 2-byte code) (eff. 4/2006)</td></tr><tr><td>(<a name=\"clm-mdcr-non-pmt-rsn-cd-.40\"> </a></td><td>MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) (eff. 4/2006)</td><td>MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) (eff. 4/2006)</td></tr><tr><td>)<a name=\"clm-mdcr-non-pmt-rsn-cd-.41\"> </a></td><td>MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) (eff. 4/2006)</td><td>MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) (eff. 4/2006)</td></tr><tr><td>+<a name=\"clm-mdcr-non-pmt-rsn-cd-.43\"> </a></td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement ('18' 2-byte code) (eff. 4/2006)</td><td>MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement ('18' 2-byte code) (eff. 4/2006)</td></tr><tr><td><<a name=\"clm-mdcr-non-pmt-rsn-cd-.60\"> </a></td><td>MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) (eff. 1/2009)</td><td>MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) (eff. 1/2009)</td></tr><tr><td>><a name=\"clm-mdcr-non-pmt-rsn-cd-.62\"> </a></td><td>MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) (eff. 1/2009)</td><td>MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) (eff. 1/2009)</td></tr><tr><td>%<a name=\"clm-mdcr-non-pmt-rsn-cd-.37\"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - California ('25' 2-byte code) (eff. 10/2005)</td><td>MSP cost avoided - Recovery Audit Contractor - California ('25' 2-byte code) (eff. 10/2005)</td></tr><tr><td>&<a name=\"clm-mdcr-non-pmt-rsn-cd-.38\"> </a></td><td>MSP cost avoided - Recovery Audit Contractor - Florida ('26' 2-byte code) (eff. 10/2005)</td><td>MSP cost avoided - Recovery Audit Contractor - Florida ('26' 2-byte code) (eff. 10/2005)</td></tr></table></div>" ]; fhir:CodeSystem.url [ fhir:value "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd"]; fhir:CodeSystem.identifier [ fhir:Identifier.value [ fhir:value "https://bluebutton.cms.gov/assets/ig/CodeSystem-clm-mdcr-non-pmt-rsn-cd.html" ] ]; fhir:CodeSystem.version [ fhir:value "1.1.1"]; fhir:CodeSystem.name [ fhir:value "Claim Medicare Non Payment Reason Code"]; fhir:CodeSystem.title [ fhir:value "Claim Medicare Non Payment Reason Code"]; fhir:CodeSystem.status [ fhir:value "active"]; fhir:CodeSystem.date [ fhir:value "2018-11-27T15:56:35+00:00"^^xsd:dateTime]; fhir:CodeSystem.publisher [ fhir:value "CMS Blue Button 2.0 Team"]; fhir:CodeSystem.description [ fhir:value "The reason that no Medicare payment is made for services on an institutional claim. Source: https://bluebutton.cms.gov/resources/variables/clm_mdcr_non_pmt_rsn_cd"]; fhir:CodeSystem.caseSensitive [ fhir:value "true"^^xsd:boolean]; fhir:CodeSystem.valueSet [ fhir:value "https://bluebutton.cms.gov/assets/ig/ValueSet-clm-mdcr-non-pmt-rsn-cd"]; fhir:CodeSystem.hierarchyMeaning [ fhir:value "is-a"]; fhir:CodeSystem.content [ fhir:value "complete"]; fhir:CodeSystem.concept [ fhir:index 0; fhir:CodeSystem.concept.code [ fhir:value "A" ]; fhir:CodeSystem.concept.display [ fhir:value "Covered worker's compensation (Obsolete)" ]; fhir:CodeSystem.concept.definition [ fhir:value "Covered worker's compensation (Obsolete)" ] ], [ fhir:index 1; fhir:CodeSystem.concept.code [ fhir:value "B" ]; fhir:CodeSystem.concept.display [ fhir:value "Benefit exhausted" ]; fhir:CodeSystem.concept.definition [ fhir:value "Benefit exhausted" ] ], [ fhir:index 2; fhir:CodeSystem.concept.code [ fhir:value "C" ]; fhir:CodeSystem.concept.display [ fhir:value "Custodial care – non-covered care (includes all 'beneficiary at fault' waiver cases) (Obsolete)" ]; fhir:CodeSystem.concept.definition [ fhir:value "Custodial care – non-covered care (includes all 'beneficiary at fault' waiver cases) (Obsolete)" ] ], [ fhir:index 3; fhir:CodeSystem.concept.code [ fhir:value "E" ]; fhir:CodeSystem.concept.display [ fhir:value "HMO out-of-plan services not emergency or urgently needed (Obsolete)" ]; fhir:CodeSystem.concept.definition [ fhir:value "HMO out-of-plan services not emergency or urgently needed (Obsolete)" ] ], [ fhir:index 4; fhir:CodeSystem.concept.code [ fhir:value "E" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - IRS/SSA/HCFA Data Match (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - IRS/SSA/HCFA Data Match (eff. 7/00)" ] ], [ fhir:index 5; fhir:CodeSystem.concept.code [ fhir:value "F" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoid HMO Rate Cell (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoid HMO Rate Cell (eff. 7/00)" ] ], [ fhir:index 6; fhir:CodeSystem.concept.code [ fhir:value "G" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided Litigation Settlement (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided Litigation Settlement (eff. 7/00)" ] ], [ fhir:index 7; fhir:CodeSystem.concept.code [ fhir:value "H" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided Employer Voluntary Reporting (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided Employer Voluntary Reporting (eff. 7/00)" ] ], [ fhir:index 8; fhir:CodeSystem.concept.code [ fhir:value "J" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoid Insurer Voluntary Reporting (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoid Insurer Voluntary Reporting (eff. 7/00)" ] ], [ fhir:index 9; fhir:CodeSystem.concept.code [ fhir:value "K" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoid Initial Enrollment Questionnaire (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoid Initial Enrollment Questionnaire (eff. 7/00)" ] ], [ fhir:index 10; fhir:CodeSystem.concept.code [ fhir:value "N" ]; fhir:CodeSystem.concept.display [ fhir:value "All other reasons for non-payment" ]; fhir:CodeSystem.concept.definition [ fhir:value "All other reasons for non-payment" ] ], [ fhir:index 11; fhir:CodeSystem.concept.code [ fhir:value "P" ]; fhir:CodeSystem.concept.display [ fhir:value "Payment requested" ]; fhir:CodeSystem.concept.definition [ fhir:value "Payment requested" ] ], [ fhir:index 12; fhir:CodeSystem.concept.code [ fhir:value "Q" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided Voluntary Agreement (eff. 7/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided Voluntary Agreement (eff. 7/00)" ] ], [ fhir:index 13; fhir:CodeSystem.concept.code [ fhir:value "R" ]; fhir:CodeSystem.concept.display [ fhir:value "Benefits refused, or evidence not submitted" ]; fhir:CodeSystem.concept.definition [ fhir:value "Benefits refused, or evidence not submitted" ] ], [ fhir:index 14; fhir:CodeSystem.concept.code [ fhir:value "T" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - IEQ contractor (eff. 9/76) (obsolete 6/30/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - IEQ contractor (eff. 9/76) (obsolete 6/30/00)" ] ], [ fhir:index 15; fhir:CodeSystem.concept.code [ fhir:value "U" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - HMO rate cell adjustment (eff. 9/76) (Obsolete 6/30/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - HMO rate cell adjustment (eff. 9/76) (Obsolete 6/30/00)" ] ], [ fhir:index 16; fhir:CodeSystem.concept.code [ fhir:value "V" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - litigation settlement (eff. 9/76) (Obsolete 6/30/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - litigation settlement (eff. 9/76) (Obsolete 6/30/00)" ] ], [ fhir:index 17; fhir:CodeSystem.concept.code [ fhir:value "W" ]; fhir:CodeSystem.concept.display [ fhir:value "Worker's compensation (Obsolete)" ]; fhir:CodeSystem.concept.definition [ fhir:value "Worker's compensation (Obsolete)" ] ], [ fhir:index 18; fhir:CodeSystem.concept.code [ fhir:value "X" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - generic" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - generic" ] ], [ fhir:index 19; fhir:CodeSystem.concept.code [ fhir:value "Y" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - IRS/SSA data match project (obsolete 6/30/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - IRS/SSA data match project (obsolete 6/30/00)" ] ], [ fhir:index 20; fhir:CodeSystem.concept.code [ fhir:value "Z" ]; fhir:CodeSystem.concept.display [ fhir:value "Zero reimbursement RAPs -- zero reimbursement made due to medical review intervention or where provider specific zero payment has been determined. (effective with HHPPS - 10/00)" ]; fhir:CodeSystem.concept.definition [ fhir:value "Zero reimbursement RAPs -- zero reimbursement made due to medical review intervention or where provider specific zero payment has been determined. (effective with HHPPS - 10/00)" ] ], [ fhir:index 21; fhir:CodeSystem.concept.code [ fhir:value "00" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - COB Contractor" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - COB Contractor" ] ], [ fhir:index 22; fhir:CodeSystem.concept.code [ fhir:value "12" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - BCBS Voluntary Agreements" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - BCBS Voluntary Agreements" ] ], [ fhir:index 23; fhir:CodeSystem.concept.code [ fhir:value "13" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Office of Personnel Management" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Office of Personnel Management" ] ], [ fhir:index 24; fhir:CodeSystem.concept.code [ fhir:value "14" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Workman's Compensation (WC) Datamatch" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Workman's Compensation (WC) Datamatch" ] ], [ fhir:index 25; fhir:CodeSystem.concept.code [ fhir:value "15" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) (eff. 4/2006)" ] ], [ fhir:index 26; fhir:CodeSystem.concept.code [ fhir:value "16" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Liability Insurer VDSA (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Liability Insurer VDSA (eff. 4/2006)" ] ], [ fhir:index 27; fhir:CodeSystem.concept.code [ fhir:value "17" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - No-Fault Insurer VDSA (eff. 4/2006)" ] ], [ fhir:index 28; fhir:CodeSystem.concept.code [ fhir:value "18" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement (eff. 4/2006)" ] ], [ fhir:index 29; fhir:CodeSystem.concept.code [ fhir:value "19" ]; fhir:CodeSystem.concept.display [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11119 (see CMS Change Request 7906 for identification of the contractor.)" ]; fhir:CodeSystem.concept.definition [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11119 (see CMS Change Request 7906 for identification of the contractor.)" ] ], [ fhir:index 30; fhir:CodeSystem.concept.code [ fhir:value "21" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - MIR Group Health Plan (eff. 1/2009)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - MIR Group Health Plan (eff. 1/2009)" ] ], [ fhir:index 31; fhir:CodeSystem.concept.code [ fhir:value "22" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - MIR non-Group Health Plan (eff. 1/2009)" ] ], [ fhir:index 32; fhir:CodeSystem.concept.code [ fhir:value "25" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Recovery Audit Contractor - California (eff. 10/2005)" ] ], [ fhir:index 33; fhir:CodeSystem.concept.code [ fhir:value "26" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Recovery Audit Contractor - Florida (eff. 10/2005)" ] ], [ fhir:index 34; fhir:CodeSystem.concept.code [ fhir:value "42" ]; fhir:CodeSystem.concept.display [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11142 (see CMS Change Request 7906 for identification of the contractor.)" ]; fhir:CodeSystem.concept.definition [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11142 (see CMS Change Request 7906 for identification of the contractor.)" ] ], [ fhir:index 35; fhir:CodeSystem.concept.code [ fhir:value "43" ]; fhir:CodeSystem.concept.display [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11143 (see CMS Change Request 7906 for identification of the contractor.) Effective 4/1/02, the Medicare nonpayment reason code was expanded to a 2-byte field. The NCH instituted a crosswalk from the 2-byte code to a 1-byte character code. Below are the character codes (found in NCH & NMUD). At some point, NMUD will carry the 2-byte code but NCH will continue to have the 1-byte character code." ]; fhir:CodeSystem.concept.definition [ fhir:value "SEE NOTE4: Coordination of Benefits Contractor 11143 (see CMS Change Request 7906 for identification of the contractor.) Effective 4/1/02, the Medicare nonpayment reason code was expanded to a 2-byte field. The NCH instituted a crosswalk from the 2-byte code to a 1-byte character code. Below are the character codes (found in NCH & NMUD). At some point, NMUD will carry the 2-byte code but NCH will continue to have the 1-byte character code." ] ], [ fhir:index 36; fhir:CodeSystem.concept.code [ fhir:value "!" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - COB Contractor ('00' 2-byte code)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - COB Contractor ('00' 2-byte code)" ] ], [ fhir:index 37; fhir:CodeSystem.concept.code [ fhir:value "@" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - BC/BS Voluntary Agreements ('12' 2-byte code)" ] ], [ fhir:index 38; fhir:CodeSystem.concept.code [ fhir:value "#" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Office of Personnel Management ('13' 2-byte code)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Office of Personnel Management ('13' 2-byte code)" ] ], [ fhir:index 39; fhir:CodeSystem.concept.code [ fhir:value "$" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 2-byte code)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Workman's Compensation (WC) Datamatch ('14' 2-byte code)" ] ], [ fhir:index 40; fhir:CodeSystem.concept.code [ fhir:value "*" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) ('15' 2-byte code) (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Workman's Compensation Insurer Voluntary Data Sharing Agreements (WC VDSA) ('15' 2-byte code) (eff. 4/2006)" ] ], [ fhir:index 41; fhir:CodeSystem.concept.code [ fhir:value "(" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Liability Insurer VDSA ('16' 2-byte code) (eff. 4/2006)" ] ], [ fhir:index 42; fhir:CodeSystem.concept.code [ fhir:value ")" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - No-Fault Insurer VDSA ('17' 2-byte code) (eff. 4/2006)" ] ], [ fhir:index 43; fhir:CodeSystem.concept.code [ fhir:value "+" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement ('18' 2-byte code) (eff. 4/2006)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Pharmacy Benefit Manager Data Sharing Agreement ('18' 2-byte code) (eff. 4/2006)" ] ], [ fhir:index 44; fhir:CodeSystem.concept.code [ fhir:value "<" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) (eff. 1/2009)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - MIR Group Health Plan ('21' 2-byte code) (eff. 1/2009)" ] ], [ fhir:index 45; fhir:CodeSystem.concept.code [ fhir:value ">" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) (eff. 1/2009)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - MIR non-Group Health Plan ('22' 2-byte code) (eff. 1/2009)" ] ], [ fhir:index 46; fhir:CodeSystem.concept.code [ fhir:value "%" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Recovery Audit Contractor - California ('25' 2-byte code) (eff. 10/2005)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Recovery Audit Contractor - California ('25' 2-byte code) (eff. 10/2005)" ] ], [ fhir:index 47; fhir:CodeSystem.concept.code [ fhir:value "&" ]; fhir:CodeSystem.concept.display [ fhir:value "MSP cost avoided - Recovery Audit Contractor - Florida ('26' 2-byte code) (eff. 10/2005)" ]; fhir:CodeSystem.concept.definition [ fhir:value "MSP cost avoided - Recovery Audit Contractor - Florida ('26' 2-byte code) (eff. 10/2005)" ] ]. # - ontology header ------------------------------------------------------------ a owl:Ontology; owl:imports fhir:fhir.ttl.
Blue Button 2.0 Version: 1.1.1 ®© FHIR Version: 3.0.1 (IG Publisher v3.0.1-11916) generated on Tue, Nov 27, 2018 15:56+0000. |
